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143: Performance Anxiety: The Conclusion

143: Performance Anxiety: The Conclusion

Session with Rhonda, Part 2

Last week we published the first half of the session with Rhonda, who was struggling with severe performance anxiety about her work as the new host of the Feeling Good Podcast host. We did the initial T = Testing, which indicated many intense negative feelings, as well as E = Empathy phase of TEAM therapy session.

This week, we include the conclusion of the session, with A = Paradoxical Agenda Setting and M = Methods, plus final T = Testing to see how effective, or ineffective the session was.

When you listen, you will see that the changes Rhonda experienced were amazing. But were these changes real? It almost seem too easy, and too fast, especially for a problem that started in childhood and persisted right up to the present moment. Was the session just a publicity stunt, perhaps, or some kind of superficial quick fix? David asks Rhonda about this, as well as this question: ‘If the changes were real, what caused such rapid and profound changes?

David and Rhonda used many TEAM-CBT techniques they during the session, including these:

David Empathized with the Five Secrets of Effective Communication at the start of the session during the E = Empathy phase. Of course, good empathy is necessary throughout a therapy session.

David melted away Rhonda’s resistance during the A = Paradoxical Agenda Setting. These techniques included:

Straightforward Invitation

Miracle Cure Question

Magic Button

Positive Reframing

Pivot Question

Magic Dial

The M = Methods that were helpful in this session included:

The Individual Downward Arrow to identify the Self-Defeating Beliefs that triggered Rhonda’s feelings of inadequacy.Rhonda enjoyed this exercise and felt it was on target. We identified many Self-Defeating Beliefs, including:

Perfectionism

Perceived Perfectionism

Achievement Addiction

Approval Addiction

Love Addiction

Fear of Rejection

Submissiveness

Inadequacy schema

Spotlight Fantasy

Brushfire Fallacy

Superwoman

The Interpersonal Downward Arrow to illuminate how Rhonda saw her relationship with her father, with David, and with some other people, including the podcast listeners. This is kind of like Psychoanalysis at warp speed. Rhonda said this felt uncomfortable, perhaps because it cast David somewhat as a dangerous ogre!

David and Rhonda smashed several of Rhonda’s Self-Defeating Beliefs with the Feared Fantasy Technique

Identify the Distortions

Paradoxical Double Standard Technique

Externalization of Voices

Acceptance Paradox / Self-Defense Paradigm

Self-Disclosure / Exposure

The Experimental Technique

Thinking in Shades of Gray

Finally, if the changes were real, will they last? Or will Rhonda just slip back into more performance anxiety and self-doubt?

You can click on this link if you’d like to review the evolution of Rhonda’s Daily Mood Log during the session. Please notice that the link is several pages long.

I want to thank Rhonda, my esteemed colleague, friend, and wonderful podcast host, for giving all of us this incredible gift of her humanness.

And I, Rhonda, want to thank the most marvelous, compassionate and incredible David Burns, for the gift of healing and facilitating me experiencing enlightenment and peace from these difficult feelings and negative thoughts that were devastating me. I feel so much gratitude for all of our work together, for your trusting me enough to invite me to be the host of these podcasts, and for the gift of your friendship. Words can’t express the full depth of my love for you and for everything you have given me both personally and professionally!

Did you like the personal work we did? Was it helpful for you personally? Rhonda took a chance and was courageous to share this intensely personal experience with you. Let us know if you liked the podcast!

If you are a therapist, or an interested patient, let us know if this was it a good learning experience. Would you like to hear more podcasts with live personal work?

We are here to serve you, so share your thoughts and feelings with us, as well as your wish list for future podcasts!

10 Comments

thanks to Rhonda for doing this, it’s very brave. And I also think that she’s doing a great job and that she will keep getting better.
I have a question. In mi opinion, when you did the externalization of voices mean Rhonda said something in the lines of ‘you are a professional and you should already know your craft and made no mistakes,…’.
What would happen if the person can’t defend that, or even if she agrees on that and becomes really discouraged or even depressed and anxious about it? Wouldn’t it be very very difficult to come back from that place. Wouldn’t that backfire and make the person much more depressed?
Cheers from Argentina guys, Andrés

All of the TEAM Therapy tools are powerful and can backfire if not used skillfully. Similar to open heart surgery. You can’t watch an operation and then take a knife and start cutting on people, and expect good results! In the old days, before I had developed really powerful methods, this was not an issue, since the tools I learned during residency training in psychiatry were not helpful, but also not dangerous. When something powerful is developed, it has the capacity for good or evil, so to speak! Thanks for good question! david

Rhonda,
I so wish I had sent this note when you first started hosting because this is what I thought from the beginning: I love the way you host – I enjoy your cheerful manner, your competence, and I immediately thought “Rhonda is on the ball.” I was surprised that you had any concerns about your abilities, but as David predicted, your openness has endeared you to me (and to others.) As a therapist, I sometimes ruminate over my errors (perceived or real.) It’s nice to know I’m in wonderful company.

Thanks for your good work. I love the personal work, and I find the podcasts most helpful in my private practice!